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Date: <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> ,~. 220 High Street NE &~<' <br /> Salem, Oregon 97301 <br /> <br />Phone 588-5147 8:00 am - 4:30pm <br />Cod~-A-Phe~: 588-7904 <br />Fnx: 5aa-7~s SITE #: <br />ELECTRICAL PERMIT APPLICATIONI Date: <br />Please complete alt Sections, I throogh 5[ ~ Issued by: <br /> <br />Permit No. <br /> <br />1. LOCATION OFINSTALLATION <br /> <br />~o~Adams. 20167 Grim Read NE [ <br />city Aurora ]c~,s~ Boones Ferry Road <br />mmcmmf High sc;hool foo'cball field <br /> <br />~,~dp~on Ser¥ige and lishting af ~oqtball <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE/F WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR 1F WORK IS SUSPENDED FOR 1 $0 DAYS. <br /> <br />:lA. cON'IgRAcTO~.INSTALLATI~N ONLY <br /> <br /> Dryden Electric In~Ph°r~ 981-3913 <br />M~i~sA~tr~PO BOX 266, ~bbard OR 97032 <br />Pn~°W~North ?hrion SchooJus IPh°~* 982-9887 <br />Co.~oe~ u~ ~o. 24-322C <br /> <br />C~atracl~s Board RCS. No. 9894B I lob No. <br /> <br /> 3138S ~lPh°n*N~81-391~' <br />Supervisors License No. <br /> <br />2B. FOR~V/I~ INSTALLATIONS <br /> <br />PLAN RE¥11~W 8F. CTION <br /> <br /> 5B and submit ~o (2) se~ of p~ ~a~s wi~ ~ <br /> ~ applie~on. <br /> <br />This optional plan review program does not suspend the <br />required submission of lighting power calculations, plans, <br />and specifications when x~quired by the Oregon Structural <br />Specialty Code, Chapter 53 .... <br /> <br />MC15-3411/91 <br /> <br />4. FEE 8CH~DIJL~(CAm~pI~e ~d en-t~r total M Al Mow) <br /> <br /> ~ Numar ~ I~l~s p~ ~lt <br /> <br />A' ~d~l~/~"lt hms ~t (each) <br />1~ ~. ~ ~s $85.00 <br /> <br />~m ~of $15.00 <br /> ~y $~.~ <br /> <br /> In~Jaflo~ ~ ~ilt~afl°nsks$ ~ Rdntlo~ ~, <br /> ~1 ~ $~00.~ <br /> <br /> ~ 1~ ~p$ ~v~ ~0.ffi <br /> Re~ ~y ~.~ <br /> <br /> ln~,.~. Alamo. ~ Rd~ <br /> <br />D. Bra~h <br /> N~, AIt~atbn~ or ~on ~r ~nel <br /> <br /> ~b~' 20 ae.~ <br /> ~se of se~ ~ f~d~ f~ <br /> <br />E. M ~l~u$ (Service ~ Feede~ Not ~ded) <br />~ ~ ~ ~ ]i~htln~ $40,00 <br />~1, d~ ~ ~ $~.00 <br /> <br /> ~er~e ~y of ~e <br /> ~, ~r ~ $~.00 <br /> <br /> ~ lOla~ ~ ~.~ ~ $~.00 <br /> <br />1. Enter total of f~s from Sec. #4 <br />A2. Add 5% s~ch$~9 (.0~ x Al) <br /> <br /> Sobtotal <br /> <br />B. Bnter 25% of lineAl for Plan Review <br /> (S~c. 3), if r~quir~d <br />C. Investigation Fee= ('ff re.q-a~eA) <br />D. Rdn~pection Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />275.00 <br />288.75 <br /> <br />$ <br /> 288.75 <br /> <br />at No, <br /> <br /> <br />